Aids and tools for stroke survivors - Occupational therapy - Stroke

Introduction to Fugl-Meyer Assessment (FMA)

The Fugl-Meyer Assessment (FMA) is a standardized testing protocol widely used to evaluate the physical performance of individuals who have suffered a stroke. This comprehensive guide provides an overview of the FMA, including its history, structure, and clinical importance, making it accessible and easily understandable for a broad audience.

Introduction to Fugl-Meyer Assessment (FMA)

Developed in 1975 by Axel Fugl-Meyer, the FMA is an index to assess the sensorimotor recovery in individuals who have had a stroke. It is one of the most extensively used quantitative measures in stroke rehabilitation worldwide. The primary aim of the FMA is to assess the progress and outcomes of physical therapy and rehabilitation in stroke survivors.

Structure of the FMA

The Fugl-Meyer Assessment is divided into five domains:

  1. Motor Functioning:
    • Upper Extremity: This section evaluates arm and hand movements, such as reaching, grasping, and pinching.
    • Lower Extremity: This section assesses leg movements, including hip, knee, and ankle motions.
  2. Sensory Function: This part measures the light touch and sharp-dull discrimination primarily in the arms and legs.
  3. Balance: The balance assessment focuses on the ability of the patient to maintain balance while sitting or standing.
  4. Joint Range of Motion: This domain tests the passive range of motion and joint pain.
  5. Joint Pain: This section assesses pain in the joints during passive movements.

Scoring System

The FMA uses a point system where a higher score indicates greater independence and motor ability. The total maximum score is 226, with the breakdown as follows:

  • Motor assessment of upper extremities (66 points)
  • Motor assessment of lower extremities (34 points)
  • Balance (14 points)
  • Sensory function (24 points)
  • Joint functioning (44 points)
  • Pain assessment (44 points)

Clinical Importance of FMA

The Fugl-Meyer Assessment is crucial for several reasons:

  • Baseline Assessment: It provides a baseline to evaluate a patient’s initial functional abilities post-stroke.
  • Tracking Progress: It helps in monitoring the patient’s recovery progress during rehabilitation.
  • Tailoring Rehabilitation: It assists therapists in designing individualized rehabilitation programs based on the specific needs of a stroke survivor.
  • Research and Development: FMA scores are used in clinical trials and research to assess the efficacy of new treatments and interventions for stroke recovery.

Limitations of the FMA

Despite its widespread use, the Fugl-Meyer Assessment has some limitations:

  • Time Consumption: The full assessment can be time-consuming, which may not be practical in all clinical settings.
  • Subjectivity: Some sections of the assessment may involve subjective judgments by the examiner.
  • Ceiling Effect: There is a ceiling effect, where patients with mild impairments may quickly achieve high scores, making it difficult to detect small but clinically significant changes.


The Fugl-Meyer Assessment remains a cornerstone in the field of stroke rehabilitation. By providing a structured and standardized approach to assess recovery, it plays a vital role in guiding treatment plans and measuring patient outcomes. While it has some limitations, its benefits in clinical practice and research make it an invaluable tool in the management and recovery of stroke patients.

This article provides a clear and comprehensive view of the Fugl-Meyer Assessment, helping patients, caregivers, and healthcare providers understand its purpose and application in the rehabilitation process.

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